Flow chart process for answering telephone for hospital

Big rewards The following strategies have proven successful in certain family practices and might be worth trying in yours.

With your goals in mind and the ability to tolerate some trial and error, you'll be on your way to better patient flow. One of the most effective patient flow strategies, visit planning is also among the easiest to implement, says Woodcock. First and foremost, visit planning requires a chart preview, normally done the day before or the morning of the visit, to determine whether all appropriate documentation is in the chart and ready for the physician. This enables the clinical support staff to alert the physician to potential problems that could derail the visit.

For example, if a nurse discovers that a test result that's critical to determining a patient's treatment plan won't be available until after the patient's scheduled appointment, the visit could be rescheduled rather than the patient and physician making this discovery in the exam room.

For example, realizing that Mrs. Jones is bringing in one son to check for an ear infection and that she always asks the doctor to check her other son, you could go ahead and have both boys' charts pulled. Refill requests, phone calls and charting all must be managed, and an emerging school of thought suggests that the most efficient way to do this is in real time, responding to these needs as they arise rather than dealing with them at the end of the day. According to Moore, successfully completing dictation and other non-visit-related work as it comes along depends on doing the following: Anticipating the work by estimating the time and resources needed allowing for direct care and non-visit-related care and carefully matching appointment times and lengths to resources.

Strategies for Better Patient Flow and Cycle Time

If continuous-flow processing seems like a more radical step than you're ready to take, the following are more traditional approaches to help prevent non-visit-related care from interrupting your patient flow. Phone calls Woodcock tracked phone calls in family practices and found that as many as 30 percent of the calls received are from repeat callers. In some cases, then, your receptionist or phone triage person has to field the same inquiry twice, look for the same chart twice, engage the nurse twice.

Weida says this strategy has helped reduce the number of repeat calls his practice receives. Look for an article about her system in an upcoming issue of FPM. The system enables her to spend more face-to-face time with patients and less time on the phone, she says. Escobedo also writes prescriptions for a full year in as many cases as possible.

Weida's practice is beginning to take advantage of the checkout process to make sure follow-up appointments are scheduled for the appropriate lengths of time by noting on the encounter sheet, for example, that the patient needs to return in four weeks for a 30-minute appointment;

At the same time, it leads to better understanding of patient issues and of the daily work that all members of the group do;

It helps team members gain a shared understanding of the process and use this knowledge to collect data, identify problems, focus discussions, and identify resources;

To speed up the referral process, Soper's practice has developed about 40 one-page instruction letters — one for each of the consultants he and his colleagues commonly refer patients to;

First and foremost, visit planning requires a chart preview, normally done the day before or the morning of the visit, to determine whether all appropriate documentation is in the chart and ready for the physician.

When requests come from pharmacies, the receptionist forwards the calls to a message recorded by Soper that asks them to fax a written request to the practice. The faxes come into the practice on a computer, are batched, printed, reviewed and signed by the doctor and then faxed back to the pharmacy, usually the same day.

Refill requests from patients are forwarded to voice mail for the nurses, who often encourage patients to have their pharmacist submit the request. Soper reports that patients and pharmacists have responded well to the system and that it has substantially reduced calls to the practice.

Chart previews and huddles can help you to determine the reason for the visit and prepare accordingly, whether that means having particular instruments and supplies ready, getting an X-ray or a throat culture done or asking an MA to write out prescriptions for a patient with several chronic conditions who will be coming in for prescription refills.

He now wants to take their efforts a step further by developing clinical protocols for several common procedures and diagnoses that will ensure that clinical support staff know the required setup and preparation. Putting people whose work is contiguous in contiguous space — or at least in close proximity to one another — is the theory behind co-location. For example, Moore says, practices participating in the IDCOP collaborative have had success at locating schedulers in the same area as the clinical team.

They can hear how the flow is going and make informed decisions about whether to try to work a patient in. Co-location helps decrease messaging flow chart process for answering telephone for hospital all of its negative consequences: At the same time, it leads to better understanding of patient issues and of the daily work that all members of the group do. For many practices, co-location requires shoehorning staff into tight quarters and, for some, the geographic limitations are too difficult to overcome.

Walkie-talkies have been a good alternative to co-location for some practices, Moore suggests. When Soper established a new practice two years ago, he was able to design his new office space with patient flow in mind.

What can I do to prevent this in the future?

He made sure the receptionist is close to the door, that the location of the reception desk enables her to view the entire room and that the design of the counter at the reception area is such that patients can fill out forms there. To minimize the amount of ground the clinical team would have to cover when taking patients from the waiting area to exam rooms he once worked in a practice where they were separated by 85 stepshe also made sure the exam rooms are in close proximity to the waiting area.

Soper designed the exam rooms so that they're just big enough to accommodate three adults and equipment, which allows him to pivot and reach most anything he needs during the exam.

He determined that three exam rooms per physician would be the minimum necessary for him to avoid delays. He also has a room without an exam table that he and his colleagues use for encounters that require limited or no physical exams. All the exam room doors are within view of the nurses' station.

Why do I have to complete a CAPTCHA?

Moore decided that he could best serve his patients interests with a continuous-flow practice style that requires just one room. To help keep the check-in process from bogging down, Soper has looked carefully at the forms patients have to fill out at check-in to make sure they're focused and well-designed so that patients can complete them relatively quickly and easily.

We'd have to go over it with the patient and put it into the electronic record anyway.

Soper reports that patients and pharmacists have responded well to the system and that it has substantially reduced calls to the practice;

High-level flowcharts are especially useful in the early phases of a project;

For example, realizing that Mrs;

Phone calls Woodcock tracked phone calls in family practices and found that as many as 30 percent of the calls received are from repeat callers;

I think paperwork is sometimes used to keep patients busy and give the system time to catch up.

I think paperwork is sometimes used to keep patients busy and give the system time to catch up. Weida's group will begin pre-registering patients in the next several months, with a secretary registering patients by phone several days before their scheduled appointments. Streamlining registration also gives practices the capacity to collect co-pays at check-in, Woodcock says. This can help the checkout process, which is often complicated by the need to manage referrals and schedule follow-up appointments.

According to Moore, successfully completing dictation and other non-visit-related work as it comes along depends on doing the following.

For many practices, co-location requires shoehorning staff into tight quarters and, for some, the geographic limitations are too difficult to overcome.

They can hear how the flow is going and make informed decisions about whether to try to work a patient in.

When Soper established a new practice two years ago, he was able to design his new office space with patient flow in mind. North River Press; 1985.

Look for an article about her system in an upcoming issue of FPM.

Soper recommends that exam rooms be stocked and the supplies and equipment be arranged in a standard way. Moore also emphasizes the importance of getting all physicians in a practice to agree on a standard set of supplies.

Soper uses dozens of templates, most which came with his EMR system and some of which he's developed himself. But you don't have to be an EMR user to benefit from the use of documentation templates. Medical Group Management Association; 2000. Simon and Schuster; 1996. The Machine That Changed the World: The Story of Lean Production.

They can hear how the flow is going and make informed decisions about whether to try to work a patient in;

When requests come from pharmacies, the receptionist forwards the calls to a message recorded by Soper that asks them to fax a written request to the practice;

Soper reports that patients and pharmacists have responded well to the system and that it has substantially reduced calls to the practice;

He determined that three exam rooms per physician would be the minimum necessary for him to avoid delays.

A Process of Ongoing Improvement. Goldratt EM, Cox J. North River Press; 1985. Despite the fact that it's the last step in the patient visit, checkout can significantly affect your patient flow —for the worse if it ties up staff time that could be better spent on other tasks or for the better if it minimizes subsequent calls to the office.

To speed up the referral process, Soper's practice has developed about 40 one-page instruction letters — one for each of the consultants he and his colleagues commonly refer patients to.

The checkout person simply fills in the diagnosis that the physician wrote on the patient's routing slip and emphasizes that the patient should call the consultant's office to schedule the appointment as soon as possible.

Weida's practice is beginning to take advantage of the checkout process to make sure follow-up appointments are scheduled for the appropriate lengths of time by noting on the encounter sheet, for example, that the patient needs to return in four weeks for a 30-minute appointment. Because some patients leave before scheduling their follow-up visits, he's also letting the patient know the length of the visit so that he or she can pass the information along to the scheduler when calling in.